Lege Artis Medicinae

[LIPS ]

MATOS Lajos

FEBRUARY 21, 2004

Lege Artis Medicinae - 2004;14(02)

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[PRIMARY TUBULOINTERSTITIAL NEPHRITIS]

FERENCZI Sándor

[Primary tubulointerstitial nephritis is characterised by an inflammatory infiltrate of tubulointerstitial space. The infiltrate consists of T and B lymphocytes, monocytes, macrophages, neutrophyl and eosinophyl granulocytes in varying degree. It is associated with interstitial oedema and different level of tubular damage. The disease exists in acute and chronic form. The main causes of this condition are: drugs, infection, systemic diseases, malignancy and in some cases the disease is idiopathic. The pathogenesis in most cases is immune-mediated. The secondary form of tubulointerstitial nephritis can occur in primary glomerular and vascular disease and is characterised by tubulointerstitial fibrosis and tubulus atrophy. The morphological alterations are major determinants of the progression of chronic renal disease. In both forms of tubulointerstitial nephritis the development of renal insufficiency is often observed.]

Lege Artis Medicinae

[QUO VADIS ]

MATOS Lajos

Lege Artis Medicinae

[LARGE VESSEL MANIFESTATION OF GIANTCELL ARTERITIS]

KOLOSSVÁRY Endre, PINTÉR Hajnalka, ERÉNYI Éva, KOLLÁR Attila, FARKAS Katalin, KISS István, HARCOS Péter, SIMON Károly

[The diagnosis of giant-cell arteritis is a real challenge for clinicians. There are several reasons for the difficulties in establishing the diagnosis. This disease is associated to rare conditions, therefore most physicians lack clinical experience. This condition shows very heterogeneous manifestation, the intensity of the symptoms vary in time. Early diagnosis is of great importance in order to prevent ischemic complications. Among these complications one should emphasise the role of anterior ischemic optic neuropathy that may result in abrupt blindness. In this case report, we show a rare socalled large vessel manifestation of giant-cell arteritis. This form of the disease needs different approach in diagnosis where color duplex ultrasonography may have distinguished importance. The final verification of the diagnosis is based on histology. However the lack of all histological criteria do not exclude the presence of giant-cell arteritis.]

Lege Artis Medicinae

[THE HISTORY OF FLUOROQUINOLONES]

LUDWIG Endre

[During the 40 year history of quinolones, from the first compounds (nalidixic acid, oxolinic acid, norfloxacin) suitable only for the treatment of mild urinary tract infections, an important group of antimicrobials was developed that can be used for the treatment of serious Gramnegative (ciprofloxacin, ofloxacin) and Grampositive (levofloxacin, moxifloxacin) infections. With the changes in the antimicrobial spectrum of the new derivatives it seems, that the clinical indications of the mainly anti-Gram-positive and the mainly anti-Gram-negative fluoroquinolones can be separated. We also learned the characteristics of their antibacterial activity that makes the optimal administration possible assuring the maximum clinical efficacy and the minimal development of bacterial resistance. The activity of fluoroquinolones can also be compromised by bacterial resistance so to preserve their clinical value it is important to follow the above mentioned principles in their use.]

Lege Artis Medicinae

[Chirurgic treatment of pyogenic liver abscess]

PETRI András, HÖHN József, HÓDI Zoltán, WOLFÁRD Antal, BALOGH Ádám

All articles in the issue

Related contents

Clinical Neuroscience

[Multiple ischemic stroke in Osler-Rendu-Weber disease]

SALAMON András, FARAGÓ Péter, NÉMETH Viola Luca, SZÉPFALUSI Noémi, HORVÁTH Emese, VASS Andrea, BERECZKY Zsuzsanna, TAJTI János, VÉCSEI László, KLIVÉNYI Péter, ZÁDORI Dénes

[Hereditary hemorrhagic teleangiectasia (HHT, Osler-Rendu-Weber disease) is an autosomal dominantly inherited disorder caused by the mutation of several possible genes and characterized by malformations of the arteriovenous system in multiple organs. The clinical diagnosis is based on the Curaçao criteria ((1) spontaneous, recurrent epistaxis; (2) teleangiectasias in characteristic sites (lips, oral cavity, nose, fingers); (3) visceral lesions (gastrointestinal, pulmonary, cerebral, spinal); (4) affected first degree relative). The aim of this study is to present the first genetically confirmed Hungarian case of hereditary hemorrhagic teleangiectasia with multiple ischemic strokes. Our 70-year-old woman has been suffering from severe epistaxis since her childhood and presented gastrointestinal bleeding during her adulthood as well. The characteristic skin lesions developed in the 5th decade of life. She was admitted to our department with loss of consciousness and fluctuating speech and swallowing problems. MRI of the brain supplemented with angiography revealed multiple arteriovenous malformations and multiple subacute ischemic lesions. The EEG demonstrated slowing of electric activity in the left frontal lobe. The neuropsychological assessment showed deficits in anterograde memory and executive functions. The diagnostic work-up for other characteristic alterations identified an arteriovenous malformation in the left lung. The genetic analysis demonstrated a heterozygous mutation in the 7th exon of the ENG gene at position 834 resulting in a thymine duplication and an early stop codon by a frame shift. The present case is largely similar to those already described in literature and draws the attention to the importance of multidisciplinary collaboration in the care of HHT patients.]